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Becker’s Healthcare Podcast
Paula Ferrada, MD, FACS, FCCM, MAMSE, Chair of the Department of Surgery at Inova Fairfax Medical Campus (IFMC), Professor of Medical Education at the University of Virginia, Division and System Chief of Trauma & Acute Care Surgery, and Medical Direc
00:16:26
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- [00:01]
A
This is Laura Dirdo with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Dr. Paula Ferrata, who is the chair of the Department of Surgery at Inova Fairfax Medical Campus and System Division Chief for Trauma and Acute Care Surgery at inova Health System. Dr. Farrada, it's a pleasure to have you on the podcast today.
- [00:18]
B
Laura, the pleasure is all mine. Thank you so much for having me.
- [00:21]
A
Absolutely. Well, I'm excited for our discussion because I know there's so much happening at Inova, especially looking at clinical care. It's just a time ripe for innovation. So I'm looking forward to diving in. But before we do, I'm wondering, can you introduce yourself and tell us a little bit more about Inova Health System?
- [00:39]
B
Yes. Yes. So my name is Paula Ferra. I am the chair, like you said, the chair of the Department of Surgery Inova Fairfax Hospital, which is our flagshield hospital. We have over 900 licensed beds, although we take care and serve more than those patients. And we are located in Northern Virginia to serve a population of 3.2 million people. We have the third busiest emergency room in the entire country, the Department of Surgery. We need more than 90 surgeons from different specialties, all cutting edge, very interesting, and very talented group of physicians. From the trauma perspective, we have a trauma system. We have a level one trauma center at Fairfax Hospital. For those of you that are not familiar, what does that mean? Level of trauma center could be level one, which is the highest acuity. Level two, same clinical acuity, but without research and residents. And level three is less acuity. And then their other levels are not recognized by the state or the American College of Surgeons. We have a level one in Fairfax and we have a level two in Loudoun. Beautiful hospital. Great teams, very capable clinicians. In terms of my background, I have been working in Inova for four years. Before I was at another at Virginia Commonwealth University, where I was the director of the ICU and professor of surgery and director of the fellowship. And I trained residents at the Beth Israel Deaconess Medical center in Boston and did an extra year of training in the University of Pittsburgh as critical Care and Trauma and an extra year of acute care surgery at Shock Trauma, M.D. and I have been practicing as a surgeon since 2008. So that's my background. In terms of leadership, I think that I have taken several courses and learned a lot, mostly from experience and from being surrounded by an amazing team and great leaders. And so I consider myself lucky in my leadership journey will continue to grow in a stretch as we go, absolutely.
- [02:53]
A
I think that's great to hear and definitely inspiring to know how you've gotten to the point where you're at from being practicing clinician into more of this leadership role. And could you expand a little bit more on your leadership philosophy? I know, grounded in the principles of level 5 leadership. Could you talk a little bit more about that and what your focus is now in driving long term success within the organization?
- [03:16]
B
Yeah, that's a great question and thank you so much for asking me that. I think that I got a junior faculty asking me this in one of our lunches last week. Why did I go into leadership? Because we all have to have our purpose clear in our why. I was never really hungry for power, recognition, but it was more that I saw what poor leadership does to the team. I saw what poor leadership, how it trickles down to everybody, how toxicity actually can destroy teams. And even though we think it's just for the physicians, everything else, everything that we do in terms of leadership or clinical care or anything that we do in a hospital ultimately touches patients and whether we want it or not. So I think that why did I get in leadership and, and training myself and surrounding myself with people that I want to emulate and doing everything that I think I dedicated my life to doing the last decade is because I wanted to make surgery particularly, but also health care a place where we can speak up, that we can mentor each other, we can protect each other, we can help each other, where we're allowed to be vulnerable with each other and where we obviously try our best to prevent mistakes, but when mistakes happens, we avoid blaming and shaming people. But actually understanding failure as a learning opportunity where we have know that we have each other's best interests at heart. Nobody in any health care system shows up to the hospital to harm somebody. We are healers. And so I think that that is the reason why I got in, that is the reason why I trained myself. I love, I'm very passionate about leadership. I read something about leadership almost every, every day. But I think when we're talking about level five leadership, it's not only about learning yourself, be your best self, changing the environment, but the capacity of mentoring other people to be leaders as well to make a change and to leave a legacy of trust in each other as a team, where people feel safe, speaking up, where people feel that we belong. So that is my leadership philosophy and that is my why.
- [05:48]
A
That's amazing to hear. Thank you so much for sharing with us and being very candid about your journey into Leadership. Now, I'm curious, can you share any specific examples or things you're most focused on right now when you're looking at applying this leadership in some of the results that you've seen from it?
- [06:06]
B
Yes, yes. Thank you. So I think that I, so I came from. I'm a foreign graduate. I was born in Colombia, South America. And it's incredible, we go straight from high school to medical school. So I started medical school when I was 16 years old and I had the opportunity of seeing how different types of changes in society changes the teams, the dynamics, the leaders, the resources. So I think. And also I had the opportunity to see in different countries serving as the Pan American Trauma Society president and all that I did before I serve in that capacity for that society, teaching people in every places of Latin America with less resources and how emotional regulations and how we show up for our team changes culturally, but also changes in the level of stress that you have. So, meaning you can have, you're going to have excellence if you, if you put your mind to it. You can have excellent emotional regulation when you sleep eight hours a night, when you take a break for lunch, when you don't have three emergencies to go through. But that changes when you understand that any mistake that you make can result in somebody's death. And when you have three patients waiting for you. And we have. When you have work for 48 hours straight without a break. Right. And so. And you haven't eaten also. Right. So this is. These are things that I think in health care sometimes we take for granted, especially during residency. We have the 80 hour work week rule to avoid from people to work more than 80 hours. But what else do we have in terms of extending compassion to your team members? All healthcare professionals. All healthcare professionals. We all have a deep compassion for patients. And that's our why and that's why we show up and that's why we train for longer years than anybody else. But can we extend that compassion to yourself and to your team members instead of going to judgment to apply some curiosity. And it's interesting because I think healthcare is one of the places where we have, where the concepts that Brene Brown talks about it very, in a very eloquent way. The concept of being vulnerable and showing up is brave and showing up vulnerable allows your team members to also be vulnerable and not be super big and bad. So you cannot talk about the things that you need to talk about to improve the care of our patients. I think how does that result when I can speak about our division, I think When I showed up at the beginning in our division, there was some culture transformation that needed to happen. Same with the operating rooms. But once you do that and once the team trusts each other, our discharges got faster, our consult times were faster. Now our relationship with the emergency medicine service, with EMS and paramedics, our relation with them is better. So therefore now we are the trauma center that gets the most EMS transfers, referrals or patients in the entire state. With the operating rooms, we changed the way that we communicate with nursing anesthesia and surgery. We created a culture of trust and that ended up improving our metrics, improving our first on time start from what we have until what we have now. So I think that even though it sounds for people that are very scientific, that want to always look at the numbers or people that are still hooked up in hierarchies or impact Factors publications and RVs use, it is interesting how all goes back to these very kumbaya concept of compassion towards yourself, compassion towards your team members having a culture of trust. And even though this seems super soft, that level of empathy always results. Or at least in my experience and I might prove myself wrong later on in my career but to now my in that in my experience it will improve your metrics, it will improve the data you have to invest in people. And honestly we're leading people, we're not leading numbers, we're not leading a metric, we're not leading a title. Right? So I think that is when you I 100% believe that through empathy and to vulnerability we can create teams that where the trust is there and we can and that trickles down to better patient care, better quality metrics, better less safety issues because people are not afraid to raise your hand and speak up.
- [11:01]
A
That makes a lot of sense and I really appreciate the explanation there because it can be very critical in the clinical care space to keep these principles in mind. But easy I think to forget them. Especially as you mentioned, when you're in a high stress environment or haven't necessarily been able to take care of yourself as a clinician and leader the way you'd like to. So that makes a lot of sense. And I'm curious, what do you typically do I guess or what are you excited about when you look into the future of medicine and see the leaders upcoming, the pipeline within your organization and beyond, what do you see as being just something that you're really excited about their energy and passion and more when you think about where healthcare leadership is headed.
- [11:44]
B
I'm really excited to see clinicians in leadership Roles. So I think. But. And those clinicians need to understand that leadership is a skill. Right? Some people are born with different types of skills, but ultimately leadership is a skill that needs to be learned, practice, and almost like daily. Right? Like a lot of introspection, a lot of reading, a lot of understanding, time invested with your team. I mean, if you're leading a team of people, it's important that you know them by name and story, not just by what they do for you or for the organization. I think when clinicians, the people that are at the bedside, the people that understand where the resources need to be placed, the people that are. That are like, you know, walking the walk, those are the people that are trained and empowered and allowed to be in leadership roles. The organization moves differently. I think that people feel less at risk, people feel more understood. There's less issues begging for what you need, because those people that have been clinicians or are still clinicians understand what the patients need. So it's less about the bottom line, but in more about serving people. And then ultimately, yes, it will make. It will make systems profitable. Of course. No money, no mission. Correct. That being said, our business is. Our business needs improving lives, saving lives, better outcomes. You know, when we fail in leadership and when we don't create those open environments for people to collaborate, it's not, it's those mistakes are, Are very, Are, are. Are. Are very costly because we're measuring our success in how we impact other people's lives.
- [13:35]
A
That's fantastic to hear. Dr. Farrada, thank you so much for joining us on the podcast today. Before we wrap up, is there anything else you would like to leave our audience with, especially emerging leaders as they're trying to navigate the healthcare system right now and figure out what it will take in order to be a great leader in the future?
- [13:54]
B
Yes, I have several things that I think that are important. I think for. For those that are listening, that want to be in leadership, start training, start looking for avenues to grow. But more importantly, understand that leadership is not really about personal power, but it's about service. And if serving is beneath you, then leadership is not for you. However, I also want to empower every clinician to understand that your leadership and your influence goes above and beyond a title of professor, associate professor, or chair, or whatever the title might be, because everybody around you are listening. The medical students are listening. The families are listening. Nursing is listening. Your partners in emergency medicine and other specialties are listening. And ultimately our why, the reason why we show up every day to the jobs that we show up for every day is to help people, to heal people. And so in order for us to do that, we have to be whole ourselves. If, if there's an issue with emotional regulation or you feel stuck in how you communicate, maybe it's important that you take a look inward, do some introspection and lead yourself understand why are you not showing up the way that you need to show up. And once you heal inside and you find an environment where you, where you feel that you can belong, where you're hurt, when you're understood, where you're belief, treasure that environment and once you're there, help others too lent a hand that's not only good for you and good for the other person, but all that secretion of oxytocin, serotonin and dopamine when you're helping people prolongs your life as well. Ultimately, it's all of our jobs, everybody in healthcare, to make this place a better place. I'm not only talking about. I know. I'm talking about globally. How do we leave something behind? How do we leave a legacy of trust and compassion so we can help others also grow?
- [16:02]
A
I love that a legacy of trust and compassion is truly remarkable. Dr. Farada, thank you so much for joining us on the podcast today. This has been a really fun and informative conversation and I look forward to connecting with you again soon.
- [16:14]
B
Thank you, Laura. Sam.